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J Clin Hypertens (Greenwich). 2017 Jul;19(7):713-721. doi: 10.1111/jch.13023.

Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: An updated review.

Author information

1
Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
2
Istituto Auxologico Italiano, Milano, Italy.
3
Department of Clinical Sciences and Community Health, University of Milano and Fondazione IRCCS Policlinico di Milano, Milano, Italy.
4
University Clinical Hospital Centre "Dragisa Misovic", Belgrade, Serbia.
5
Hypertension Centre Hospital V. Fazzi, Lecce, Italy.
6
Istituto di Ricerche a Carattere Scientifico Multimedica, Sesto San Giovanni, Milan, Italy.

Abstract

Reverse or inverted dipping (ie, the phenomenon characterized by higher nighttime compared with daytime blood pressure values) is an alteration of circadian blood pressure rhythm frequently documented in hypertension, type 2 diabetes mellitus, chronic kidney disease, and sleep apnea syndrome, and generally regarded as a harmful condition. Available literature on the clinical and prognostic implications of reverse dipping is scanty. The present article will review a number of relevant issues concerning reverse dipping, in particular: (1) its possible mechanisms; (2) prevalence and clinical correlates, (3) concomitant cardiac and extracardiac subclinical organ damage; (4) association with acute and chronic cardiovascular diseases; (5) prognostic value in predicting cardiovascular events and mortality; and (6) therapeutic interventions aimed at reverting this abnormal circadian blood pressure rhythm.

KEYWORDS:

cardiovascular disease; cardiovascular prognosis; hypertension; reverse dipping; target organ damage; treatment

PMID:
28692165
DOI:
10.1111/jch.13023
[Indexed for MEDLINE]
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